What does nerve pain feel like?

Tingling. Numbness. Burning pain. Weakness.

If you’ve experienced these kinds of symptoms, you may be wondering what’s causing them — and whether they’re something to worry about.

One possible explanation is peripheral neuropathy, a condition caused by damage to nerves outside the brain and spinal cord. Peripheral neuropathy most commonly affects the hands and feet, though symptoms can also occur in the arms and legs.

For some people, symptoms are mild and occasional. For others, nerve pain can interfere with sleep, mobility and everyday activities.

The good news is that treatment can often help reduce symptoms and, in some cases, address the underlying cause. 

Peripheral neuropathy symptoms

Peripheral neuropathy symptoms can vary depending on which nerves are affected and how severe the nerve damage is.

Many people describe the sensation as tingling or “pins and needles.” Others report burning, freezing, stabbing or electric shock-like pain. Symptoms may come and go at first, then gradually become more persistent over time.

Numbness is also common. Some people lose sensation in their hands or feet, while others become unusually sensitive to touch. Even light pressure from socks, blankets or shoes may feel painful.

Peripheral neuropathy can also affect muscle control and coordination. You may notice weakness, balance problems or difficulty with fine motor tasks such as buttoning clothing or opening jars.

When the condition affects the feet or legs, walking and driving may become more difficult. If it affects the hands, everyday tasks like typing, cooking or holding objects can become frustrating. 

Peripheral neuropathy causes

One of the most common causes of peripheral neuropathy is diabetes. Over time, high blood sugar levels can damage nerves, particularly in the feet and legs. About half of adults with diabetes develop some degree of peripheral neuropathy.

Chemotherapy is another leading cause. Certain cancer treatments can damage nerves during or after treatment, a condition known as chemotherapy-induced peripheral neuropathy.

Vitamin deficiencies may also contribute. Low levels of vitamins B12, B1 and E are all associated with nerve damage.

Alcohol use can also play a role. Excessive alcohol consumption may directly damage nerves and contribute to nutritional deficiencies that worsen symptoms. Some studies estimate that up to two-thirds of people with alcohol use disorder experience peripheral neuropathy.

Autoimmune diseases sometimes attack healthy nerves by mistake. Conditions linked to peripheral neuropathy include Guillain-Barré syndrome, lupus, Sjögren’s syndrome and rheumatoid arthritis. Certain infections may also lead to nerve damage, including shingles, HIV, hepatitis and Lyme disease.

In rarer cases, exposure to heavy metals or toxins — such as lead, arsenic or mercury — may contribute to peripheral neuropathy symptoms.

Because so many different conditions can cause nerve pain, it’s important not to ignore ongoing symptoms. 

Peripheral neuropathy diagnosis

If you’re wondering how a doctor would test for peripheral neuropathy, the first step is usually a discussion about your symptoms, medical history and any underlying health conditions.

Your doctor may ask when symptoms started, where they occur and whether they’ve been getting worse over time. They’ll also review medications you currently take or have taken in the past. A physical exam can help evaluate muscle strength, reflexes, balance and sensation.

Depending on your symptoms, additional testing may include blood work, imaging or nerve function tests such as electromyography (EMG) and nerve conduction studies. In some cases, skin or nerve biopsies may also be recommended.

Testing can help identify both the presence of nerve damage and the underlying cause, which is important for guiding treatment. 

Peripheral neuropathy treatment

Peripheral neuropathy treatment depends on what’s causing the condition and how severe symptoms are.

In some cases, nerve damage may improve over time. For example, some people regain nerve function after completing chemotherapy treatment or correcting a vitamin deficiency.

Other cases may be long term, especially when nerve damage is more advanced. In those situations, treatment focuses on managing symptoms and improving quality of life.

Several medications may help reduce nerve pain, including certain anticonvulsants and antidepressants. Topical treatments, such as creams containing capsaicin, may also provide relief for some people.

Physical therapy and occupational therapy can also help improve balance, mobility and day-to-day functioning.

If you’re experiencing ongoing tingling, numbness or nerve pain, don’t ignore it. Talking with your doctor can help identify the cause and connect you with treatments that may help you feel better and stay active.